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Browsing by Author "Shrestha, Niranjan"

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    Scrub Typhus among Febrile Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Shrestha, Sanjeeb; Pradhan, Shanti; Shrestha, Niranjan; Karn, Mitesh
    Abstract Introduction: Scrub typhus is an acute febrile illness caused by obligate intracellular bacteria of the family Rickettsia after an incubation period of 6-21 days. The disease may lead to several complications such as acute hepatitis, sepsis, myocarditis, respiratory distress and disseminated vasculitis if not treated properly. The aim of the study was to find out the prevalence of scrub typhus among febrile patients admitted to the Department of Medicine in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among febrile patients admitted to the Department of Medicine in a tertiary care centre from 12 November 2020 to 11 May 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 26/076-077). All patients with acute febrile illness from 17 years to 70 years were included. Patients with an acute febrile illness diagnosed with other infections such as dengue, leptospirosis, typhoid, brucellosis, malaria, and COVID-19 were excluded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 640 patients presenting with acute febrile illness, 38 (5.94%) (4.11-7.77, 95% Confidence Interval) patients were diagnosed to have scrub typhus. Among 38 patients, 2 (5.26%) patients suffered from acute hepatitis, and 1 (2.63%) each suffered from sepsis, myocarditis, disseminated vasculitis and respiratory distress. Conclusions: The prevalence of scrub typhus among patients admitted to the Department of Medicine was found to be slightly higher than in other studies done in similar settings.
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    Service Readiness of Primary Health Care Facilities for Non-Communicable Diseases Management
    (Nepal Health Research Council, 2024) Sharma, Yam Prasad; Kaphle, Hari Prasad; Shrestha, Niranjan; Upadhyay, Jagat Prasad; Poudel, Sujan
    Background: NCDs prevalence and associated risk factors impacts on the burden of disease and premature mortality. Effective NCD service delivery requires well equipped facilities with trained providers and resources. Evaluating readiness and its determinant is crucial for enhancing NCD management. The study examines readiness in primary health care facilities for managing non-communicable disease in Syangja district. Methods: A cross-sectional research was conducted among 117 Primary health care facility health workers in Nepal's Syangja District. The data was collected through face-to-face interviews using modified WHO-SARA tool. The chi-square test was used to evaluate the relationship between NCD readiness and its associated factors and multivariable logistic regression was utilized to determine the strength of the correlation. Results: Only 6 percent of the healthcare facilities in Syangja district had developed the system for readiness against non-communicable diseases. The mean percentage scores for service-specific domains ranged from 40% to 58%, indicating variations in readiness across different domains mainly contributed by basic amenities and training. Approximately 80.3% of health facilities received support from the local government, while equipment or commodities support was provided to the third- quarter of the health facilities. Conclusion: Total service readiness was very low in the diagnostic and medicine facilities of Syangja. It demonstrates that there is a discrepancy between the present situation of the incremental trend of NCDs and the related level of service preparedness in primary health care settings. The development of the service readiness mechanism is imperative considering the increasing prevalence of non-communicable diseases in Syangja. Keywords: Non-communicable disease, Primary health facilities, Service Readiness

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